2CU-11539-67194

3 vaccinations 7 coded responses 29 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 660 / KS
Registered: 2021-02-26

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-29
Dose 1 — Moderna
2021-02-26
Registered in v-safe
2021-02-26
Dose 2 — Moderna
2021-02-26
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Good · Site: Redness

Free text: Bruising at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Good · Site: Redness

Free text: Bruising at infection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-30
Survey response — 3 months, dose 2
MedDRA: Blood thyroid stimulating hormone decreased, Immunisation reaction — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: TSH thyroid reading lower & in hyperthyroid range c

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-27
Survey response — 6 months, dose 2
MedDRA: Blood thyroid stimulating hormone decreased — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Needed to reduce dosage of sythroid medication due to Unusual drop in blood TSH levels.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-27
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Call 1 — Left Voicemail
2021-10-26
Dose 3 — Moderna
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Survey response — day 7, dose 3
MedDRA: Dizziness, Headache, Pyrexia — Feeling: Good

Free text: Two days after the booster I felt lightheaded or a few minutes. Not normal at all for me. Other than headache a occasionally feverish, felt normal 4 days after shot.

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-25
Survey response — 3 months, dose 3
MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Covid-19

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-01-26
Call 1 — Left Voicemail
2022-04-26
Survey response — 6 months, dose 3
MedDRA: Post-acute COVID-19 syndrome, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Tested positive for Covid 19 in December, 2 months after booster vaccine. Currently experiencing long Covid symptoms.

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-27
Call 1 — Left Voicemail
2022-10-26
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna
3	2021-10-26	Moderna	No

Call center

4 call center cases

4 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-03-01

Systemic reaction (other): Bruising at injection site

2021-03-02

Systemic reaction (other): Bruising at infection site

Release 8 — 3 months, dose 2

2021-05-30

Symptoms: TSH thyroid reading lower & in hyperthyroid range c

Release 9 — 6 months, dose 2

2021-08-27

Symptoms: Needed to reduce dosage of sythroid medication due to Unusual drop in blood TSH levels.

Release 10 — day 7, dose 3

2021-11-04

Systemic reaction (other): Two days after the booster I felt lightheaded or a few minutes. Not normal at all for me. Other than headache a occasionally feverish, felt normal 4 days after shot.

Release 11 — 3 months, dose 3

2022-01-25

Symptoms: Covid-19

Release 11 — 6 months, dose 3

2022-04-26

Symptoms: Tested positive for Covid 19 in December, 2 months after booster vaccine. Currently experiencing long Covid symptoms.

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
SD	Blood thyroid stimulating hormone decreased	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Immunisation reaction	✓	✓	✓
SD	Post-acute COVID-19 syndrome	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Headache	·	·	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Pyrexia	·	·	✓

✓ active code · ○ coded but marked inactive · blank = not in that release